New Rules of Training: Top 10 + 1 Training Tips for Running

Dr. Pribut’s New Rules of Training

A top 10 +1 listing of training tips

Summertime is when many begin training for a fall marathon. But whatever season it is you read this, here are some training tips to keep in mind.

  • Don’t overtrain
  • Train within your current fitness level. Your safe training speed limit will vary from one distance to another.
  • Train at different distances and speeds.
  • Forget the 10% rule while you build up your distance for marathon training. I recommend a two weeks gentle increase followed by a drop back in the third week. Then you can pick up where you’ve left off. This is called “two steps forward, one step back”.
  • Aerobic conditioning should come before speed. Consider going for aerobic conditioning, strength, and speed in that order. Arthur Lydiard was one of the first to systematically recommend this in the order o: Distance, Hills, Speed.
  • Get adequate rest. Make sure you rest after hard workouts and be sure to try and get a good night’s sleep.
  • Pay attention to your nutritional needs. Be sure to get adequate nutrition in a healthy balanced diet. Assess your needs. If you are diabetic, fine out what you need to do. If you are overweight, determine your real caloric needs. Find out where you are going wrong. Seek advice on a sensible diet. Follow the diet, document what you eat, and weigh your portions. If you have other eating issues, assess it and be honest. Get help if you need it. Don’t cut calories or relatively cut calories by working out hard without replacing your needed nutrients.
  • Gradually ease into your speed work. Begin with small speed spurts 100 meters, 200 meters scattered into a longer run after a warm up of a few miles of easy running. Later add in speed play, fartlek and then defined intervals. Tabata workouts are fine for fitness enthusiasts but won’t do much for your marathon training.
  • Use the running shoe, running stride, and foot strike that works best for you.
  • Pay attention to your body. Don’t ignore pain, learn from it. Know what is normal and what is not normal. Seek professional advice if it is not getting better.
  • Don’t forget to taper before a race and reverse taper after the race.

Also see:

Dr. Pribut’s tips for a successful marathon

Dr. Pribut’s tips to avoiding running injuries

Summer running tips

 

Quick Tips on Running Shoe Lacing

Shoe Lacing Systems

What are laces good for?

Laces help keep your shoes securely on your foot. They should apply pressure evenly and appropriately. Not too tight, not too loose. Just the way the story Goldilocks and the Three Bears would have described it.

Once you have found the perfect lacing system you are sure to discover it changes before very long. Running shoe manufacturers often change the position, orientation and spacing of the eyelets and the lacing system. One would like to believe it is an evolution to greater comfort, efficiency and fit. But appearance and marketability plays at some role.

Over the past few years though, the lacing system that many manufacturers have been adopting returns to a long established standard and is much easier to modify.

Selected Lacing Systems:

  • Traditional
    • Conventional diagonal (Chevron)
    • Conventional Parallel
  • Reduced Pressure Parallel
  • Skip Lacing Pattern
  • Loop Lock Lacing
  • Double Lacing (for wide forefoot and narrow heel)

What Problems Can Laces Cause?

Too loose overall:

  • Foot slips around in the shoe
    • Plantar fasciitis
    • Tendonitis
    • Posterior Tibialis tendinopathy
    • Flexor Digitorum Longus tendinopathy

Too Tight overall

  • Uncomfortable
  • Parallel lacing can help

Anterior ankle pain

  • Nerve compression
  • Tendon compression
  • Cure : lower lace by an eyelet

Midfoot compression or hot spot

  • Pain in midfoot
  • Compresses nerves and tendons
  • Cure : skip lace pattern
  • Make sure you remove the laces from any “tongue guide” loop
skip lace
skip lace

Tight toe box

  • Pinched nerve
  • Neuroma
  • Bunion pain
  • Hammer toes
  • Aggravate incurvated toenails

Band elastic laces

  • Often too loose
  • Too tight
  • Uneven compression

Barrel clips or locks

  • Can feel like big lugs banging up against your foot
  • They can be irritating, aggravating, and annoying

Slipping heel

 

  • Use a lock loop at the top
Lock loop lacing

Wide Forefoot, Narrow Heel

  • Double lacing (2 sets of laces) for each foot

Even Cooler Top Ten Winter Running Tips

I’ve just finished an interview with a very fine Washington Post reporter on cold weather running and been inspired to make sure my tips are up to date.

Winter running is something that long time runners will do because they like being outside. It is not a time to begin an outdoor running program. And you need to be in good health and be aware that if you are over 40 or have heart problems you should have your physician’s ok. Cold weather winds blasting the face can slow up your heart and adversely affect your cardiovascular system. Every winter an enthused oldster, and sometimes not so oldster shovels their driveway and has a serious heart attack. So, as they say, “be careful out there”.

But if you are healthy and used to running in the cold, you will find it refreshing. In my area we do not have any bad air days during the winter months. You’ll find the same mental and emotional effects from running as you are accustomed to getting.

So with that in mind here are some winter running suggestions:

1. Cover your head, hands, and feet with care. Dress in layers. Use lightweight wicking fibers as the layer closest to your body. Wind blocking materials are great for an outer layer.
2. Keep your feet dry. Wear socks made of synthetic fibers that wick moisture away from your skin to help prevent blisters, athlete’s foot, and cold injuries to your foot (immersion foot, frostbite, etc.).
3. Protect your skin and eyes from UV solar damage which can cause premature aging of the skin and eye damage. Use sun block and moisturizers as appropriate. UV exposure is not good in the winter as well as summer. Sunglasses during mid-day runs can be helpful.
4. Don’t forget to replace your fluids on long runs.
5. Make sure you have the energy to finish your run. Fuel up lightly 30 minutes before your run.
6. Warm up slowly and gently before your runs and especially before doing speed work.
7. Wear sport specific running shoes. Fit your running shoes or other sports shoes with the type of sock you intend to wear them with. Do replace your running shoes often. Replace them at least every 350 – 450 miles run. Be sure to transition very slowly and carefully to new running shoes, particularly when switching to a dramatically different style of shoe.
8. Don’t run on ice. Beware of Black Ice on the pavement.
9. Be careful running in low light conditions. Beware traffic and uneven pavement. If you have any balance problems run in good lighting conditions.
10. Don’t do speedwork in bone chilling cold. You are risking injury. Most wise runners use this season for maintenance runs.

For more information see my article on Running In The Cold

Low Heel Drop And Achilles Tendonitis

Two articles currently up on the Runner’s World news and blog areas take opposite approaches to Achilles tendon problems. One cites a study of normal individuals who were asymptomatic and measured “load” in the Achilles tendon and concluded that there would probably be no help given by a heel lift. This was not a clinical study of treatment however and it has no validity regarding statements made about treatment. In fact the least helpful part of many studies is in the “discussion” part of the study where the authors speculate about what their study means, but which their study did not show. Please beware of author speculation. There are only a few who are accurate in their speculations. And some of them win Nobel prizes.

The other article is a blog by a coach who noted that her runners seemed to be having an inordinate amount of calf and Achilles problems. These are clinical and coaching observations and not a published study. But, there truly may be wisdom in systematic observations. Over the past 6 months she noted that this injury seemed to have surged and become a trend. The calf and Achilles problems were often seen among runners who had thought they were purchasing the same shoe they had run in for years only to find that the “heel drop” (heel to forefoot height differential)  had dramatically decreased. Initially I was going to post on Coach Jenny’s blog article  but I’ll just link to it and make my remarks here.  I believe she is right on top of things in her blog.

Over the past 3 years many manufacturers have attempted  to “minimize” nearly their entire product line. A shoe which had a 12 mm heel drop, now has 8 mm. And of course zero to 2 mm are often touted as the ideal. But the reality is that not everyone responds well or even the same to changes.

As George Sheehan said “we are all an experiment of one”. And the modern reality is that studies, trends, and memes are aggregate while injuries happen to individuals. And individuals need tailored solutions that are not always the trendy advice making the rounds.

So in spite of  some “nay-sayers”, who adamantly disagree, I side with Coach Jenny. Often returning those 4 mm or so back as a heel lift, can make the difference between comfort and pain. Instead of a soft gel or foam heel lift, I prefer a solid heel lift made of firm layered plastic film, hard rubber, or leather. You may find that after months of icing, foam rolling, massage and even lower heel drop shoes, this may be your answer. But if you’ve had the pain that long, you may need to check in with your sports doc. (And hope the advice is different from what has failed during your experiments!)

This is still not the entire answer for many individuals and there are other things to analyze. Shoe changes, training changes, terrain, and recent racing history along with individual biomechanics all come into play for a more complete analysis of the causes and the likely solutions. YMMV

 

 

 

Artificial Intelligence And Intelligence

AI has made tremendous strides in the past 15 to 20 years. In going from a constraints and rules based system in which “expert systems” were hailed as the future, to today’s probabilistic and stochastic systems we’ve come a long way. There are many current and future uses for AI and they are far too many to list.

Some recent work has been done in gait simulations in which everything from dinosaurs to people walking with osteoarthritis or cerebral palsy (crouch gait) has been modeled. Strategies have been proposed to lessen the load on the knee using one model. But the strategy was difficult to adapt and I believe only the author of the study was able to successfully and readily use his “intoe” strategy. (Note: Lateral wedging on orthotics has also been found to lessen medial compartment forces in the knee. And that does not need you to study at Monty Python’s Ministry of Silly Walks, to walk like Young Frankenstein or to sing “Walk This Way” while you move about.)

Biorobotics, a new field of robotics, has been used to model a variety of animal methods of locomotion. Snakes, cats, fish, and human like robots have been created for this purpose.

The October 7th edition of Science Magazine features an interesting article which suggested that artificial intelligence products were needed to make connections and correlations for novel ideas on research projects. (Gill, Y et. al. 2014; 346:171-172). This is an excellent idea.

An intelligent system should be at the core of many systems. It should be at the core of all EHR (electronic health records). Some of the advocates, designers, and marketers of these products seem to be first interested in market penetration and are proud of achieving a government defined Level 2 of “meaningful use”. However meaningful use is losing its cachet since it doesn’t add intelligence, thought, or many things that are helpful to a medical record. Insted it adds more data points but not meaning. (ICD 10 coming to a healthcare provider near you next year will also add an incredible amount of not very useful datapoints and has been precicted to cause many physicians to leave private practice.)

AI could be helpful. AI could have assisted by creating a red flag notice on the Electronic Health Record that the patient with a headache and severe stomach pain had just arrived from Liberia. It was entered into the medical record of the hospital but set off no alarms.

Of course the final failure was a human one. The doctors, nurses, and residents should have made connections. It really doesn’t take a computer to put information like that together. The close partner of the patient who brought him to the hospital is said to have informed 3 people that he had come from Liberia, Africa. He did not have a Texas accent. He had more than one classical sign of Ebola or other serious illness. He rated his GI upset at 8/10, he had a fever and a headache and did not have signs that he had a sinus infection as some articles stated.

In this case an intelligent system could have made up for the unwise human conclusions and actions. But there are a few simple lessons:

1) We need to be intelligent and make connections. A diverse knowlege base is helpful.
2) We need to exclude data points that don’t make sense and are suspicious and not likely.
3) We need to have an intelligent core to our EHRs. One in which probabilty and hidden Markov Processes are used will be far better than just using Natural Language Processing (NLP) but it will be harder to implement.
4) The humans are the final arbiters of the decision making process and need to think and understand their own thinking process to produce optimal decision making and to determine the optimal next step in treating their patients.

“The world faces deep problems that challenge traditional methodologies and ideologies. These challenges will require the best brains on our planet. In the modern world, the best brains are a combination of humans and intelligent computers, able to surpass the capabilities of either one alone.” Well stated by Gill (2014).

AI-ScienceMag-small
AI Connections via the Hanalyzer.

 

References:

Gill, Y et. al. Amplify scientific discovery with artificial intelligence.  Science Magazine 20 14; 346:171-172

Ijspeert, Auke. Using robots to emulate and investigate agile locomotionScience 10 October 2014: Vol. 346 no. 6206 pp. 196-203.

Exercise is good for the mind and the soul

Another study has demonstrated that those who exercise regularly have a decreased incidence of depression.

The new study titled “Depressive Symptoms and Physical Activity During 3 Decades in Adult Life” appeared in JAMA Psychiatry in the issue published Oct 15, 2014.

At each age group, those who exercised had a lower incidence of depression than those who did not. Those who took up exercise were doing better 5 years later than those who continued to not exercise.

This is one more reason to exercise regularly. Exercise is good for ails you or for what might ail you in a few years!

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Moving is Exercise (Competing Tunes below)

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Examine Your Models and Theories Often

I’ve been spending far too much time doing 140 character mini blogs or actually enjoying MOOCs (massive open online courses). My favorite MOOCS may be found at EdX.org and Coursera.org. If you are not currently involved in a formal course of study, there probably is no better way to spend time learning than these. But it is time for at least a short blog.

So, off we go to theory. We see many theories proposed and many adopted with little study. We may see a study of 13 people or 20 people that some purport to change all thinking on a long standing medical problem. This is not the proper way to approach a poorly designed and implemented study or even a well designed but entirely all to preliminary study.

We would not change the treatment of heart disease, any type of cancer, or try to prevent Alzheimer’s disease on evidence as weak as this, but somehow it is deemed worthy of a sea change for running injuries. A shower and a change into clean clothes is likely a better use of your time.

But allowing models and theories to last for far too long can be an equally troubling problem. But this is why models and theories must be thoroughly examined. There is no need to adopt an untested theory. And there is no value in making a theory about how to treat a clinical entity and proposing that is how all such entities should be treated without testing clinical results.

Now on to yesterday, in the hope of having a better tomorrow, today!

 

Quinta_Essentia_(Thurneisse)_illustration_Alchemic_approach_to_four_humors_in_relation_to_the_four_elements_and_zodiacal_signs-small

 

Examine your theories and models often.

The model of “humors” as the cause of diseases persisted for over 2,000 years. The Greeks refined this concept in about 400 BC and it persisted for far too long.

Aristotle’s scientific publications also lasted for far too long as unquestioned dogma. And there is even recent praise in both film and print for the wonders of his study of biology. While Aristotle may have been the first to take a systematic approach to science, it is even more important to know your failings and where your knowledge is lacking. A recent book and a documentary by evolutionary biologist Armand Leroi called “Aristotle’s Lagoon” have interesting points to bring forward about Aristotle and his study of Biology. But I’m in the camp of believing that he may have done more harm than good by not successfully encouraging others to better study and verify or disprove his theories. He certainly was a busy thinking man for his time. But unexamined, he dominated western thinking for far too long.

Old knowledge isn’t necessarily knowledge at all. It is more likely a historical artifact or relic. Most medical studies from 100 years ago would not past muster today. So using them to justify someone’s completely unscientific theories is absurd. And I, like many, will even have questions about studies performed last week.

And below we have David Attenborough describing (via Louis Armstrong’s words) what a wonderful world is and Otis Redding performing Sam Cook’s song of that name. (And via the wonders of Youtube you can also find Sam Cook, Dr. John, and even Joey Ramone doing one or the other of these songs.)

 

 

 

 

 

Art And Dissent

Photograph: S Pribut

Art And Dissent

Recently a Miami, self-styled artist, feeling neglected, went to an exhibition, picked up an ancient Han Vase which was the subject of another artists work, and dropped and broke it.

This was not cool. And it wasn’t even original. Been there and done that was the artist whose work it was. In fact the dude broke the million dollar vase in front of a picture of Ai Weiwei doing it himself. So, this derivative artist created nothing new. The act had no meaning and it was not original. In fact it was done in ignorance and not out of creative feeling, impulse or thought. It was at the level of a monkey flinging shiz. The artist did not know the value of the vase and clearly didn’t understand the nature of Ai Weiwei’s work or the purpose of art and museums which display art. (In a sense, it is like blowing up the Army Mathematics Research Center (AMRC) at the University of Wisconsin in Madison and declaring that this act was to call attention to the new math.)

He claimed that he felt “inspired and a feeling of solidarity” with Ai Weiwei. But the feeling of solidarity and empowerment I felt from Ai Weiwei was that Ai Weiwei allowed visitors to photograph his exhibit. Photography is generally forbidden at visiting exhibits at most museums. But while here in DC at the Hirshorn Museum all photography was allowed and I was allowed to bring in any camera I desired.

What is never allowed is touching the art objects. So, no matter what one thinks of any art or any modern art, if you visit museums regularly or if you produce art, you know not to touch the art work. Picking up and destroying a piece of art that is owned and produced by another is not art and is not protest. It is vandalism. What was done was the equivalent of taking a hammer and knocking the nose off of a Michelangelo statue. It is like slashing a Rembrandt or the Mona Lisa.

In fact Wikipedia has a whole entry on “Vandalism of Art“. The article states “Restorations were costly and time consuming and in many cases were followed by shielding the artwork from future attacks”. I don’t know about you, but I like to see my art up close and personal. I don’t like to see it behind a screen, glass or other barrier. Looking at Michelangelo’s La Pietà through a thick glass plate was not a moment of aesthetics. The glass plate was covered with dirt, grime and finger prints. The statue was hardly visible. It was a moment of consternation. Why did some person have to damage this work of art so that no one visiting the Vatican would ever be able to see it properly again. Michelangelo’s David was also damaged by a fruitcake with a hammer and the result was some broken toes.

Ai Weiwei had clearly stated in many places that the artwork he himself dropped and photographed and the ones he painted were Han vases. Some of us may have doubted that was true, but no one doubted that it was Ai Weiwei’s artwork. Whether it was a $25 model or a $1 million vase, the artwork was that of Ai Weiwei and not for some random person to destroy.

The lesson is be you crazy, misguided or whatever “don’t break other people’s stuff in museums”. It will ruin it for the rest of us. As I mentioned, I can’t see the Pieta up close and personal. In fact I found it hardly visible at all behind the thick and dirty glass. There was no longer an art experience there. I haven’t been to the Louvre, but I’m not sure I want to bother looking at the Mona Lisa behind a thick piece of glass from several feet away. The intricate detail can only be seen up close. Vandals have made this a necessity. Will all art one day be viewed only online or through protective glass?

It is laudable that Caminero’s friends are having an auction to help with his legal costs. But hopefully they will also learn the lesson that others art has value, as they value their own. Busting up, defacing, and damaging artwork in a museum is not a creative it is destructive of all artwork, past, present, and future. It is not helpful to those who want to view artwork, have a relationship with the art, artwork, and artist though experiencing the exhibits. From the article in the NY Times it seems they do know the lesson and while they support the friend, understand his motivation, they do not support his act. While I don’t think he needs to spend 5 years in jail, restitution and acts of penance are in order.

Ai Weiwei’s art of dissent is legitimate. Caminero’s act is ill advised, ill considered, and illegitimate.

You are welcome to make your own art, give it away, blow it up (where legal), or let others deface it for you. But leave the stuff in the museums alone. You are now welcome to done one old and badly fit pair of “No Excuses” Jeans. You may rip and patch them to your heart’s content.

Behind The Smashing Of A Vase

Artists Friends Auction for Defense Funds

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